When pain, no gain

According to Wikepedia the origin of the expression "No pain,  no gain" goes back as far as the second century A.C.  At that time though it was referring to spiritual rather than physical activity - unless a person endures some spiritual search or suffering - he or she won't achieve any spiritual gain. 

In America this expression was revamped and became and exercise motto that promises greater value rewards for the price of hard and even painful work. Under this conception competitive athletes are required to endure pain and pressure to achieve professional excellence.

The motto expresses the belief that solid large muscle is the result of training hard and suffering sore muscles repeatedly, implying that those who avoid pain will never reach a professional level as athlete.  Beneficial pain refers to that resulting from tearing microscopic muscle fibers, which will be rebuilt more densely, making a bigger muscle.

It came into prominence after 1982 when actress Jane Fonda began to produce a series of aerobic workout videos. In these videos, Fonda would use "No pain, no gain" catch phrases for the concept of working out past the point of experiencing muscle aches.  This catch phrase is perfect for marketing because it encapsulate a simple concept and, enforced in memory, rolls off the tongue as a nursery rhyme.

As we all know everything genius is simple.  Unfortunately the reverse is not always true.  Pain in this case usually leads to serious re-strain and re-sprain traumas and, at times, could end athlete's career.  Pain is a signal of the body on the existence of injury, disorders or dysfunction. A phenomenon of skeletal muscular injuries disorders or dysfunctions always manifested as elevated resting tone of muscles, which then be transmitted to tendons, ligaments and other tissues. Described muscular conditions, should be viewed as a precondition to significant muscles or ligaments tears that, at times, require surgeries.  Besides, when athletes suffer from pain and tension in muscles and, in some cases also in fascia, they cannot perform to the best of their physiological potential.

Because of this, or maybe because the words pain and gain that rhyme so well in English, and don't rhyme in other languages, the motto perhaps didn't stick in other countries.  Well I can bravely say this for the Russian language where the word "pain" sounds like bol` and  the word "gain" like priobretat`.

In any case coming from Russia the concept of "No pain, no gain," when it was introduced to me, seemed quite foreign.  This introduction has occurred in a quite peculiar way.

When I arrived to the US, I was hired by a physical therapy company as a staff trainer, to teach Russian Medical massage methodology. Since the primary goal of this methodology, from its inception, was treatment of patients, one of its major emphases was placed on avoiding traumas. Therefore medical massage always starts with very light pressure and in inhibitory regime.

This regime allows for gradual increase in pain threshold, which in turn permits gradual increase of pressure without activating of the pain analyzing system. 

When a therapist continues to provide massage while pain analyzing system is activated, it is likely that not only a therapist is going to reach his/her treatment goal, but also would aggravate client's condition.  For detail please read the article Reaction vs. Aggravation.
If you ever be asked by healthcare professionals to explain scientific part of what you are doing you are welcome to give these references. They will be acceptable and scientifically sounds.  

Most of the physical therapists, physical therapists assistant, and physical therapy aides, who have had  worked for this company, had no problem with this approach. However, there were some who objected.  Specifically I remember one heavy set, tall, muscular physical therapist who looked like a line-backer.  At the moment my English was quite rusty but I remember him referring to Medical Massage approach something not manly.  He was the first one who familiarized me with "No pain, no gain" motto and its application to massage therapy, promoting vigorous pressure.  According to him Americans were tough people and were ready to endure pain to reach results.  There were also other who insisted that pain sensation after treatment as a positive reaction.

Luckily this company used to employ more than 120 physical therapists, and most was following my teaching to avoid activating pain analyzing system and traumatizing clients.  Faster and more sustained results were achieved almost in all cases. I am very happy to say that the "line-backer," due to clinical outcome, changed his mind in regards “no pain, no gain“ and started following protocols everyone used successfully.

I remember how, while participating with fibromyalgia support group, I listened to one well known rheumatologist, who deeply doubted the effectiveness of deep tissue massage on human body.  As a proof of his position he showed me the list of 200 of his patients, who incurred fibromyalgia after receiving deep tissue massage.  

I assured him that deep tissue massage has nothing to do with sudden application of vigorous pressure and told him about the value of introductory massage, gradual increase of pressure as application of the Gate control theory and four strategies for deep tissue massage.  I also told him about massage therapists who neglected such careful and gradual approach, professing immediate vigorous pressure and who, most likely, inflicted trauma  and caused incurring fibromyalgia in his patients.  Subsequently, he referred me many fibromyalgia clients allowing me to help them managing their symptoms.

Contemplating about the differences in deep tissue massage approach, I am remembering one of my students.  He was of Chinese nationality, immigrant from Vietnam, who came to my school, sharing with me his life story.  He told me that he was considered a "black sheep" in his family for his inability to learn.  He also shared with me his dream of healing people with his hands. 

I accepted him to my school and noticed that despite being slightly uncoordinated, due to overexcitement, he had quite capable hands.  In general, he was a very eager to learn student.  After graduating he was accepted to one of the famous spas and started his quick rise to prominence.  However, apparently not being satisfied with what he knew, he took some extra courses.  He was taught, as he was explaining me, the version of deep tissue massage that emphasizes vigorous pressure as in "No pain, no gain."  Despite my objections, he insisted on this method that he thought was superior.  Unfortunately this lead to many clients being traumatized and him being eventually fired from the spa and, of course, it is to no surprise of mine.

Vigorous pressure,  persisted while pain analyzing system is activated causes development of myositis, tendinitis, microscopic tears of soft tissue, development of trigger points and many other pathologies.

In retrospect I can rephrase the "No pain, no gain" motto as "When pain, no gain."

Dear colleagues,

This blog contains a few links to the important information.  For 40 years I'm practicing scientifically developed massage protocols and all offered information is based upon real scientific data, related to the science of massage.

I know, that there is new trend out there ”show me the references.” Many times people request these references, just for the sake of requesting for they don't know what to do with them.

Most of my references are in Russian.  However, below I'd like to offer some Western references in English from the books of Dr. Ross Turchaninov. While writing these books, he undertook  a truly titanic work on collecting and verifying them.  Both Dr. Turchaninov and I are trained and practice medical massage as it was proposed by Prof. Sherback, therefore references that he offered are applicable for articles I provided the links above.  Again, I included only small portion of his references, those that I checked myself. 

Thinking back though at my entire career, during the last 20 years at the US many times I have presented to medical doctors, physical therapists, doctors of chiropractic medicine.  No one ever asked me for references. I guess the material I presented sounded scientifically enough.

As for me - references do not provide treatment.  Our hands do.

And  while we are on the topic of hands ... If you visit out fan page at 

http://www.facebook.com/FreeInstructionalandSelfMassageLessons  you will find many free lessons, including almost 4 hours hands-on performances: ”Orthopedic massage physical therapy aide program Part1"

REFERENCES

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